Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | 25MA8027500 | NJ |
N | 2081P2900X | Pain Medicine | MD-074300-L | PA |
N | 2081P2900X | Pain Medicine | MD074300L | PA |
Y | 2081P2900X | Pain Medicine | ME146438 | FL |
NPI | 1093769614 |
---|---|
Provider Name | Zach Broyer |
First Address | Aventura, FL 33180-1251 |
Second Address | Aventura, FL 33180-1251 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 07/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2074348000 | IBC (01) | PA |
2886235 | AETNA (01) | PA |
5005060 | CIGNA (01) | |
H59375 | (02) |